MMS Workshop Registration
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Please complete a separate form for each person. Click here for fee details.

Name ______________________________________________________________

Address ____________________________________________________________

City ____________________________________________________ State _____ ZIP __________

Home Phone _____________________________ Work Phone _______________________________

Please check all that apply:

Montessori Teacher: Infant _____Toddler _____ 3-6 ____6-9 ______ 9-12 _____ 12-15 _____15-18 _____

Intern _____, Assistant/Aide _____, Parent _____, Administrator _____, Other ______

School with which you are associated: _______________________________________________________

Address _______________________________________City _____________________________ ZIP_________

E-mail Address________________________________________________________________________________
Please note: The Michigan Montessori Society will be providing most communication in electronic format.
Your e-mail address is essential in the future. We will not share or distribute your address in any way.

Membership:

I would like to become a member of the Michigan Montessori Society. Enclosed is my $15 membership fee.

Name ______________________________________________________________________

Address ____________________________________________________________________

City ________________________________________________ State _____ Zip ___________

Home Phone _______________________________ Work Phone _________________________

E-mail Address________________________________________________________________________________
Please note: The Michigan Montessori Society will be providing most communication in electronic format.
Your e-mail address is essential in the future. We will not share or distribute your address in any way.

Do we have permission to publish your name, address, phone number and email in the MMS directory? Yes ____ No ____

Payment:

Make checks for workshop and/or membership fees payable to Michigan Montessori Society. Please send check(s) and
registration form(s) to: MMS, 466 N. John Daly, Dearborn Hts., MI 48127 Attn: Seminar Registration